job. my wife works for all large medical firm -- a large medical firm and she cannot afford their insurance. we have our own business -- a small business. we do not have insurance with that. mike point is that -- does this -- my point is this -- does this effect how her company would price the policy for her, since it was so expensive that most of the employees -? would it our business, with 12 employees, be able to afford coverage if we decide to buy a policy with that? host: do you have any questions for him? guest: do you know if your wife's insurance plan -- how much of a percentage of her income it would cost?

under the law, this will not take effect until 2014, she may be able to go and buy insurance on the exchanges that are set up. the policy through her employer would cost more than, i believe, at 8% or 9% of income. it is more than a certain percentage of the income she may be able to go on the exchange. and may qualify for subsidies. if not, she does have to stick with her employer policy. for you, it sounds like a of a small business so you might want to look like how much this would cost and whether the tax credit will help you. that starts this year. guest: how -- the line caller: how will i find out? guest: the president said within a month it will put out information on how to apply for the credit. if you need to look at the company right now and look at restrictions. you have 12 employees, so you will have to look at the 12 employees and with average salaries are and have the below $50,000.

you have to pay at least -- i think half the cost of insurance policy for your workers. caller: do you know if they have to be full-time employees? they are contract. guest: that i don't know. i am not at that level of detail. host: why don't you offer health insurance? caller: it is a new business. we open did about 30 days ago. most of these people -- i don't know if you know much about the beauty industry, but they are mostly contractor people. they work commission. they are not hourly employees. host: have you looked at the cost of health insurance and how much it would cost you as an employer? caller: i called blue cross blue shield, cigna, it was so high that i just disconnected the phone call. guest: that is an issue. all the time, we have to see what happens with premiums. but that is one of the things that has driven the whole debate, how will slow the growth

of premiums, especially for small businesses like yours. host: here is an employer who did look into it but saw that it was economically not feasible. 2014, you say the exchanges began, or the subsidies. . some people will be on the plan that will not have been on the plan before. that kicks in in 2014. i am going to sign up for that after all. some small businesses and others may say, we just cannot afford this. here is another opportunity on this exchange, so we are not going to offer it anymore.

there is going to be some shifting around. host: i am making up some big companies -- the xerox and ibm, why would they not say we will take the $600 hit per employee -- >> it is more than that. i believe it is $2,000. they want to attract and retain good employees and they see this as a benefit, a way to keep people. they may say this is better benefits than what you get. we want to keep offering id. that is what most folks think will happen. most large employers will continue to offer coverage. host: james, republican, north carolina. good morning. caller: i have a question about the part of a bill where your child can stay on your insurance until the age 26. i must say employee in south carolina -- i am a state

employee in south carolina and my daughter graduated a year ago. she had to come off my insurance and cobra was too high, so i did not sign her up for that. will i be able to put her back on my insurance? guest: yes, that is what they are saying will happen. the secretary may have different rules for that. you may not be able to put her on your policy until your next open enrollment.

host: concord, california. caller: i have some questions about my coverage -- kaiser permanente a senior advantage. i understand that cuts to this program will take place at the election in 2011. it is wonderful coverage ha compared to the regular medicare. people like me -- are we going to be able to keep this coverage, or are we looking at 40% premium increases? what happens to the seniors? the reason for this is the medicare advantage plans, currently on average, pay

guest: the insurer's offer e insurers often offer additional benefits that are not required by the law. things like vision care, dental care, free gym membership, low or premiums, or zero premiums. some parts of california, some folks don't pay premiums at all. some of that may change. you may see your premium, if you don't have a premium, you receive premium. you may see option of benefits but they can't cut your required medicare benefits. so, we will see. i don't know if you remember back in the late 1990's and early 2000's there were cuts to medicare and at that time that it ravenna's plans were called medicare plus choice. there were a number of insurers who pulled back or dropped out of certain areas and some raise premiums. .

they are adding some things to the medicare advantage program. if they have a doughnut hole in their plan, they would get this rate this year. there are some other things in medicare -- they would start requiring free screenings for certain cancers. you would not have to pay a " pay or deductible, which may affect some folks in medicare advantage. there are some other things that are supposed to help the overall program. host: the next call is from ohio, a republican. caller: i have a couple of questions. my wife is on social security disability. i have been unemployed since june of last year. we're not able to get in -- to

get our prescriptions paid for. we have no insurance. she just went on medicare. she was receiving $738. host: what was your question? get collar >> how can we get prescriptions -- caller: how can we get prescriptions paid for? host: thank you. let's see what we can find out. guest: she can sign up for medicare part d, which covers prescription drugs. there are some programs through some of the drug companies that help with either free or low- cost prescription drugs which you can apply for. it generally tends to be a lot of paperwork. your doctor has to fill out forms. there are programs like that. you may eventually be able to

qualify for health insurance through these exchanges when they start in 2014. depending on your income, you may also qualify for a federal subsidy to help you buy that coverage. you would then have prescription coverage. we talked to some of the drug companies. see if your wife can get on the medicare part d program. host: what is the relationship between the two unit of kaiser? guest: there is no relationship at all. we are a program of the family foundation. host: the next call from florida. caller: this is my first call and i am a little nervous. i am a construction worker. i own my own business. i have catastrophic health-care

coverage. i go to the doctor once a year to get checked out. i pay for all of it myself. that is how i have decided to live my life. the question i have is will it change now? will i be forced to buy health care coverage? i am a male. i probably will never get ovarian cancer. will i have to buy that type of coverage that i do not need or do not want? host: a couple of questions. how old are you and how much you pay for your catastrophic? 36 caller: 36 years old and about 230. i have employees. five of them. host: to you offer them catastrophic health insurance? caller: i do not.

i pay them well enough. i feel that if they wanted, they can go out and get it themselves. stay on the line in case she has any questions. guest: what is your deductible? caller: i am not sure. guest: if you want to keep your plan, you can keep it. the plan is not going to change. caller: will i be forced to buy a health care? i have catastrophic health care. i do not have anything that covers going to the doctor. a little over a couple of years ago, i got a bit of mercer in my leg. i went to the immediate care center. it cost me a little over $200 and another $200 for the lab. it came back, and they gave me an antibiotic.

it ended up costing $800 because i am allergic to keflex. and in other antibiotic. the pharmacist found something for me that was cheaper. i do not want to pay for a health insurance that covers ovarian cancer, which is something i will not get. it does not cost more in the long run? guest: overtime you may want a different policy. you may go to the exchange and bought a policy. after 2014, you may have to buy a policy that will cover more than what you have now. the policies that will be available on the exchange, the minimum coverage will cover 60% of your average medical costs. you would pay the rest.

it may be more generous than the plan you have now. it may cost a bit more as a result. you may choose to buy it. here is what will change for you in 2014. if you get sick between now and then -- if you get a disease or herself on the job. insurance cannot reject you. you would be able to change plans. that is not true today. if you were to get ill and try to change plans, they could to change plans, they could reject you if you decided you did not like your current plans or wanted different coverage, you would be able to change. you will not be forced to buy something you do not want. the make an interesting poll about the ovarian cancer. -- you make an interesting point about the ovarian cancer. you are paying in in case something happens to you. that is the idea of insurance

that we all contribute money and pulled it together, hoping that nothing bad happens, but we are ensuring other people at the same time. gas -- host: why is the pre- existing thing delayed until 2014? guest: a lot economists and other folks say that to make that work, to say to insurance companies that you have to cover everybody, you also have to require pretty much everybody to have insurance. otherwise, they might wait till they are sick to buy insurance, which will raise costs. it appears those two things together. that is why we are seeing that happen together. getting it to happen in the first couple of years would have been really hard. host: after 2014, is getting hit by a truck a pre-existing condition? guest: you would still be able to get insurance.

host: s.i., arthur. caller: my compliments to you. -- complement to the host. [unintelligible] you have been so clear and concise in providing information. you should be in congress. my question, real quick. as far as the health insurance companies are concerned, is there any information on the breakdown as far as what they get and the services they provide? you have answered most of my questions. guest: i think your question is what of the insurance companies. to be required to do and pay.

there are a number of things that affect them. they will not be able to reject you anymore in 2014. this year, they cannot cancel your policy which is a fairly rare occurrence it can be a big deal if you are in that 1%. that is going to be a change. they have to report how much they are spending on direct medical care such as administrative costs. some of it is disease management. there are salaries and profits. they will have to tell this secretary how much they are spending on each of those things. starting next year, if they do not reach a certain targets, they have to give some of that

money back to consumers. if you are in a small group plan or individual plant next year, 80% of the revenue must be spent on medical care. that is if you are with a small group plan. a 5% if you are with a large group plan. and that is immediate. -- 85 cent% if you are with a le group plan. and that is immediate. caller: my question is about medicaid. i was disabled. already under our governor's things he did, i am experiencing loss mostly in prescriptions and restrictions.

it seems to make no sense that basically it is treating people as well we are all cookie cutter people. everybody gets the same thing. host: thank you. what about at the state level? guest: in medicaid, there are moneys that are available to health basic health preventative. for people that make too much to qualify for traditional medicaid but not enough for private coverage -- there will be held for states with those programs. i think they can start applying for that this year. in 2014, it expands to cover more people.

if you do not have children, you are not eligible for that matter how little money you make. that will change. they would expand medicaid for that whether or not they have kids. the states will start paying their share in some years. they are concerned. we will see many more people covered by medicaid. host: how much money is being spent? guest: i do not know what the number is this year, the cost is going to be $9.8 billion over the 10 years.

it will reduce the deficit by $124 billion over 10 years. those estimates that far out in 20 years are uncertain. taxes this year, there is a fee this year. if the good to a tanning salon, a 10% additional tax. that goes to help pay for some of those programs. there will be a tax on drug makers. those happen further out. the taxes are likely to be passed onto consumers.

it will happen after the exchange's get going. host: republican, st. petersburg, florida. caller: c-span need an alternative viewpoint. kaiser is following the obama talking points. they are a big cheerleader. they did not find anything wrong with the plan. everything she is describing is going to increase the cost of health insurance. the silver plan which is 7% will cost about $19,000 -- 70% will cost about $19,000. you save money with an unsustainable and hot mud from the government that as a $38 trillion medicare liability.

host: you have a question? caller: i am a doctor. i will be penalized if i go over budget for my patients. they will say, you cann-h spenda certain amount for spine surgery. if he spent over it, we will cut 5% and call you a bad name in the newspaper. patients coming to the doctors will not be able to trust the doctors, because they will get more if they spend less on their patients. why should we ration care that way using government power? host: stay on the line in case she has questions for you. we did not invite her to be an advocate for an opponent. she is an analyst. that is what we are doing today. talking about the immediate effect. what immediately goes into effect for you as a doctor? caller: i am a brain and spine

surgeons. they say some programs save money. but they hurt people. people that get circuit aborted by their doctors because they are afraid of getting a bad report card. guest: some of these things are occurring through insurance companies doing different things in trying to determine which are the most efficient doctors and practices. they are kind to steer patients to use high-quality doctors and whatever they want to label them or call them. he made a couple of points that may or may not be correct. they talked about what will happen in the premiums. some wilthere are going to go u. they were going up on average 8% a year already. the hope is that this

legislation will slow that premium growth over time. in 2016 when a lot of this is fully implemented, premiums for large employer plans will be about they would if this law had not changed. premiums for small businesses may go down or make up by 1%. premiums for individual policies may go up 10% or 15%, because of these changes. for half of the people, there would be subsidies to offset the cost. doctors are concerned about this. it depends on what specialty they have. he is a brain in spine surgeons. i do not know if there are perks

in there for him. for primary doctors, there are purser medicare and medicaid. they say we need to get more doctors involved in primary care and some of the specialties. there are a few other changes like that. the rationing argument has been raised. there has been debate about that. the bill calls for a preview of comparative substances. it specifically says they cannot use this information to make coverage or payment decisions. for the first few years, and number of things are excluded from that. host: the board of directors is the association of health care. what is that? guest: a professional association for journalists.

host: new jersey, independence line. caller: i have a comment than a question. and want to echo what the previous caller said. this woman has found nothing wrong with this bill. host: we did not invite her to be a proponent or upon it. we are analyzing. if you have a question about the immediate effect, we will take it. otherwise we will move on. caller: my question is, she keeps using these numbers from the congressional budget office. what i want to cite is the fact that they are using bogus numbers, 10 years worth of revenues and the program only covers six years. host: thanks. a response to that. guest: the cbo is an independent group that does this work for

congress. i do not have any other numbers for you right now. host: we are talking about the immediate effect of health care. louisville, ky. caller: police did not cut me off. you gave that dr. a lot of time. julie, thank you for accurate information. i wanted to ask you a question. i am on medicare. i treasure it and i monitor it very carefully. i get a statement every time i go to the doctor telling me exactly what medicare paid. it has always been on a timely basis. i am pained when hundred $43.50 a month to united healthcare for a supplement. -- 4143.50 and month to united

healthcare for a supplement. -- $143.50 a month to united healthcare for a supplement. medicare paid $78. medicare paid $78. my sup my supplemental paid $14 in the difference. i was livid. i have to call them every time. host: what is your question? caller: i want to know if there is going to be any control on the supplemental insurance companies. host: julie. guest: not that i know of. the doctor has a certain charge and insurers pay a certain amount of that, they may not pay the whole thing. it sounds like your supplement is picking up some of the things, but not the whole